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ANCC Adult-Gerontology Acute Care Nurse Practitioner (AGACNP-BC) Exam Review A+ Graded
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ANCC Adult-Gerontology Acute Care Nurse Practitioner (AGACNP-BC) Exam Review A+ Graded...
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ANCC Adult-Gerontology Acute Care Nurse Practitioner(AGACNP-BC) 2024-2025 Exam Review A+ Graded
H. Pylori Eradication therapy - ANSWER Resistance: Develops quickly to Flagyl and
Biaxin
Does not develop quickly to amoxicillin or tetracycline
Combo options: 2 antibiotics+ PPI or bismuth
Quadrants and Abdomen pain - ANSWER LLQ diverticulitis
RUQ galbladder
Peri-umbilical- appendicitis
Causes of Obstruction - ANSWER Adhesions
Cancer
Impaction
GERD - ANSWER A disorder characterized by back flow of acidic gastric intents into the
espohagus
Causes/Incidence of GERD - ANSWER Incompetent lower esophageal sphincter
delayed gastric emptying
S/S of GERD - ANSWER retrosternal burning, bitter taste, belching, dysphagia,
excessive salivation, occurs at night or in recumbent position, relieved by sitting up
Diagnostics of GERD - ANSWER consider referral for EGD: rule out CA, Barrett's
esophagus
,Management of GERD - ANSWER Elevate HOB
Avoid ETOH, caffeine, spices, peppermint
stop smoking and weight reduction
antacids PRN
H2 blockers (-tidines)
PPI (-zoles)
GI/Surgical consult PRN
Acid anti-secretory agents for PUD - ANSWER H2 receptor antagonists "dines":
Cimetidine (tagamet) Ranitidine (zantac) Famotidine (pepcid) Nizatidine (Axid)
Proton Pump inhibitors "zoles": Lanzoprazole, (prevacid) Omeprazole(prilosec)
pantoprazole (prilosec) ans Esomeprazole (nexium) Used for patients that cannot
discontinue NSAIDS as well
Mucosal protecting Agents PUD - ANSWER "coats"ulcers
sucralfate, Bismuth, Misoprostol (may stimulate uterine contraction-abortion)
Antacids: Milanta and Maalox, do not decrease gastric acidity
H-Pylori therapy - ANSWER combination therapy used for 7 days
2 abx + proton pump inhibitor or bismuth (less popular bc QID dosing)
use cocktail because resistance develops quickly to metronidazole (flagyl) and
Clarithromycin (Biaxin)
But not to amoxicillin and or tetracycline
so ABX 2X a day with meals and Omeprazole (prilosec)before meals
Antiulcer therapy follows this prilosec and H2 blockers for 3-7 weeks
Hepatitis - ANSWER Inflammation of the liver, with resultant liver dysfunction
types: A, B, C, E, G
,Hep A - ANSWER an enteral virus, transmitted via the oral fecal-route and rarely,
parenterally
Contaminated water and food; oral sex!
blood and stool are infectious during 2-6 week incubation period
Hep B - ANSWER Blood borne DNA virus present in serum, saliva, semen, and vaginal
secretions.
Transmitted via blood and blood products, sexual activity and mother fetus
Hep C - ANSWER Blood bore RNA virus in which the source of infection is often
uncertain
Traditionally associated with blood transfusions
50% cases are related to IV drug use
Leading cause of liver transplant
S/S of Hepatitis - ANSWER Pre-icteric: Fever, malaise, anorexia, N/V, headache,
aversion to smoking and alcohol
Icteric: Weight loss, jaundice,pruritus, right upper quad pain, clay colored stool, dark
urine
Lab/diagnostics of Hepatitis - ANSWER WBC: low to normal
UA: proteinuria, bilirubinuria
Elevated AST and ALT (500-2000) norma 35-40
LDH, bilirubin alkaline phosphatase and PT nl or slightly increased
Hepatitis treatment - ANSWER Increase fluids to 3,000 to 4,000/day
no/low protein diet: cause ammonia
Serax if sedation is necessary
Vit K for prolonged PT (>15 sec)
, Lactulose 30ml orally or rectally for elevated ammonia levels: hepatic encephalophathy
Diverticulitis - ANSWER Inflammation or localized perforation of one or more diverticula
with abscess formation
Causes/Incidence of Diverticulitis - ANSWER More common in women than men
Higher incidence in those with low dietary fiber
S/S of Divictulitis - ANSWER mild to moderate aching abdominal pain in LLQ
Constipation or loose stools
Nausea and vomiting
Physical findings of diverticulitis - ANSWER Low grade fever
LLQ tenderness ot palpation
Lab/Diagnostic of Diverticulitis - ANSWER Mild to mod leukocytosis, elevated ESR, Stool
heme + in 25 % of cases, plain and films are obtained on all patients to look for evidence
of free air
Surgical consult
Management of inpatient diverticulitis - ANSWER NPO dependent upon condition
IV fluids
IV abx: Flagyl, Cipro, Fortaz, Clindamycin, Ampicillin
Cholecystitis - ANSWER Inflammation of gallbladder, associated with gallstones in >90%
of cases
S/S of cholecystitis - ANSWER Often precipitated by a large or fatty meal
Sudden appearance of steady, sever pain in epigastrium or right hypochondrium
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